Coverage less than 50% where vaccination was optional and unavailable on-site

Action Points

Note that a survey study of healthcare practitioners revealed generally high utilization of flu vaccine last year, but rates could be improved among those who work in long-term care settings.

Another survey study found the rates of flu vaccination among pregnant women to be lower than ideal.

Most healthcare personnel received a flu shot during the 2016-2017 season, with the highest coverage among those who worked at hospitals, CDC researchers found.

While more than three-quarters of healthcare personnel reported receiving the influenza vaccination, that number jumped to 92.3% of all healthcare professionals working in hospitals, reported Carla L. Black, PhD, of the CDC's National Center for Immunization and Respiratory Diseases, and colleagues.

Lower coverage was observed among healthcare personnel working in long-term and ambulatory care settings, and in healthcare facilities where the employer did not provide or recommend vaccination coverage, the authors wrote in the Morbidity and Mortality Weekly Report (MMWR).

They noted that the CDC's Advisory Committee for Immunization Practices (ACIP) recommends that all healthcare personnel receive the influenza vaccine every year. The team conducted an opt-in internet panel survey of 2,348 healthcare personnel to provide estimates for the 2016-2017 influenza season.

Overall coverage is similar to vaccination coverage reported over the last three influenza seasons, and not surprisingly, continues to be highest (96.7%) in settings where an employer requires vaccination, the investigators said.

Ensuring that healthcare personnel and patients are protected from influenza requires workplace strategies to improve vaccination coverage among healthcare personnel, "including vaccination requirements or active promotion of on-site vaccinations at no cost."

Notably, 93.7% of healthcare personnel working in hospitals said their employer either required vaccination coverage or provided on-site vaccination for at least 1 day. Vaccination coverage was at least 90% for hospital employees "of all occupational groups," the authors said.

Only about 40% of respondents reported that receiving the influenza vaccine was part of their job requirement. About 70% of hospitals were likely to have this requirement compared with less than 40% of those working in ambulatory care, a quarter of long-term care healthcare professionals, and 22% of those working in other clinical settings.

Moreover, vaccination coverage was the lowest among healthcare personnel where vaccination was not "required, promoted, or offered on-site" (45.8%). Around 30% of workers in long-term care and "other clinical settings" said that their employer did not require, promote, or provide vaccination compared with about 20% of those in ambulatory care settings and less than 4% of those working in hospital settings.

Vaccination coverage was lower among healthcare professionals working in ambulatory (76.1%) and long-term care settings (68.0%). Black and colleagues noted that influenza vaccination in long-term care settings is "especially important because influenza vaccine effectiveness is generally lowest in the elderly, who are at increased risk for severe disease," and it "confers health benefits to patients, including reduced risk for mortality."

More Pregnant Women Who Get Offer from Their Provider Get Flu Vax

A second CDC study in MMWR, by Helen Ding, MD, and colleagues, found that a higher portion of pregnant women received the flu shot who received an offer of vaccination from their healthcare provider.

The researchers examined data, also from an internet panel survey, of 1,893 respondents who were pregnant between October 2016 and January 2017. Overall, 56.3% of women who were either pregnant or planning conception during the 2016-2017 influenza season received the flu shot. Over two-thirds of women reported that they received an offer from their provider for the influenza vaccine, and among those women, vaccination coverage was around 70%.

About 12% said they received a recommendation, but no offer, and about 20% said they received no recommendation. Coverage among those women was 43.7% and 14.8%, respectively.

"Use of evidence-based practices such as provider reminders and standing orders could reduce missed opportunities for vaccination and increase vaccination coverage among pregnant women," Ding and colleagues said.

They further noted that while providers may believe they are giving a recommendation for vaccination, the recommendation may not be communicated effectively. A recent survey conducted by the American College of Obstetricians and Gynecologists found that all surveyed providers said they recommended the influenza vaccine to patients, but only 85% of patients reported receiving a recommendation for the vaccine.

Ding and colleagues found that vaccination coverage was lower among black women, but higher among Hispanic women compared with white women, despite similar percentages of women reporting they had received a recommendation for vaccination from their provider. Similar to the findings from prior research, vaccination coverage was also lower among women with public insurance compared with those with private or military insurance, and among women with less education.

"Further work is needed to understand and address barriers to receipt of influenza vaccination" by these groups, the authors concluded.

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